阻塞性睡眠呼吸暂停低通气综合征患者手术前后口咽腔测量分析

目的　探讨阻塞性睡眠呼吸暂停低通气综合征 (obstructivesleepapnea hypopneasyndrome ,OSAHS)患者口咽腔扩大的程度与疗效的关系。方法　对 38例OSAHS行悬雍垂腭咽成形术 (uvulopalatopharyngoplasty ,UPPP)的病例进行手术前后口咽腔测量 :悬雍垂基底宽、悬雍垂长、悬雍垂至咽后壁间距、腭舌弓间距和腭咽弓间距。并观察呼吸暂停低通气指数 (apnea hypopneaindex ,AHI)、体块指数 (bodymassindex ,BMI)、血氧饱和度 (oxygensaturation ,SaO2 )的变化。结果　OSAHS患者手术前的腭舌弓间距和腭咽弓间距比对照组窄 (P <0 0 5 ) ,而至咽后壁的距离 ,悬雍垂长、宽两组数据间差异无显著性 (P >0 0 5 )。手术后腭舌弓间距、腭咽弓间距、至咽后壁的距离与对照组比较差异无显著性 (P >0 0 5 )。有效组和无效组比较 ,手术前呼吸暂停低通气指数、体块指数、最低SaO2 、平均SaO2 、悬雍垂至咽后壁间距、腭舌弓间距和腭咽弓间距、悬雍垂长、宽在统计学上差异无显著性(P >0 1)。结论　OSAHS患者的口咽部左右径小于健康人 ,而前后径与健康人相近。UPPP手术可以显著扩大咽腔口咽部左右径 ,达到健康人水平。UPPP手术疗效不仅仅与解剖结构异常有关 ,还存在其他影响因素

Orophargngeal measure in patients with obstructive sleep apnea-hypopnea syndrome before and after uvulopalatopharyngoplasty

Objective To explore the relationship between the extent of enlarged oropharynx and efficiency through measuring the anterior posterior and transverse diameter of orophargnx of patients with obstructive sleep apnea hypopnea syndrome(OSAHS) before and after uvulopalatopharyngoplasty (UPPP) Methods Thirty eight patients with OSAHS were studied The following indexes were measured before and after UPPP: width of uvula base, length of uvula, distance between uvula and posterior pharyngeal wall(DBUP), distance between anterior pillar(DBPP), apnea hypopnea index(AHI), body mass index (BMI) and SaO 2 Results The preoperative DBAP and DBPP were significantly less than those of normal adults( P <0 05) DBUP, length of uvula and width of uvula base has no significant difference between preoperative patients and normal adults( P >0 05) There was no significance diffrence in DBAP DBPP and DBUP between postoperative patients and normal adults( P >0 05) The preoperative AHI, IBM, minimal SaO 2, mean SaO 2, DBUP, DBPP, DBAP, length of uvula and width of uvula base has no significant difference between good responders and nonresponders( P >0 1) Conclusions Transverse diameter of OSAHS patients is shorter than that of normal adults but anterior posterion diameter of OSAHS patients has no difference compared with normal adults Transverse diameter could be enlarged by UPPP Not only anatomical abnormality but also other factors will contribute to the effect of UPPP